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Donor discs used to treat back disorders

The transplanted discs can be seen in MRI scans of the patients’ necks

(Image: Keith Luk, Dike Ruan and The Lancet)

Spinal discs from dead donors have been successfully transplanted into five people suffering neck problems, doctors in China report.

The breakthrough was achieved without the need for immunosuppressant drugs, and could lead to innovative treatments for debilitating back disorders, such as severe degenerative disc disease.

Spinal discs are made up of cartilage and fibrous tissue and have a jelly-like centre that acts as a shock absorber between vertebrae.

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Keith Luk at the University of Hong Kong and Dike Ruan at the Naval General Hospital in Beijing used donor discs to replace a damaged disc in the neck region of one female and four male patients – a condition which was causing pain in all of them. The patients’ average age was 47.

Special tissue

Five years later, previous symptoms such as numbness, muscle weakness and stiffness of gait had improved in all the patients. None of them had significant neck pain, although in one patient the vertebrae spontaneously fused, causing some neck stiffness.

Prior to the procedure, one of the patients with degenerative disc disease suffered serious nerve damage which paralysed him, stopping him walking. “After the operation the patient could walk with the help of a crutch,” says Ruan.

Importantly, none of the patients had an immune response to the foreign tissue, even though immunosuppressive drugs were not used. “Anatomically, this is a special tissue. There is no blood supply to the centre of the disc bringing in immune cells,” explains Ruan.

Currently, the usual treatment for back pain due to worn discs is painkillers and physical therapy. Spinal fusion, a surgical operation in which two vertebrae are fused together, is a treatment of last resort. Even when the operation successfully alleviates pain, it often causes decreased back mobility and degeneration of the discs between nearby vertebrae.

The researchers say that using the same technique in the lumber spine will prove more challenging, because the anatomy of the area and the loading are more complex.